- Highmark Health (Sacramento, CA)
- …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- Sharp HealthCare (San Diego, CA)
- …is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, ... effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of...risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc. + Policy and Procedure… more
- Actalent (Irvine, CA)
- …procedures to identify gaps, overlaps, and alignment opportunities for integration and audit readiness. + Migrate documents into systems like Propel and SharePoint, ... or equivalent discipline is required. Additional Skills & Qualifications + RAC Certification is preferred. + Experience with post-market and change management… more
- Prime Healthcare (Ontario, CA)
- …over quarter improvement in CMS Value Based Purchasing Program.9 Serves as the Assistant RAC Coordinator in consultation with HIM Director and PHS Revenue Audit ... team.10. Establishes and implements a mechanism for ongoing communication with nursing/patient care staff and conducts senior rounding with staff and patients/families on a routine basis.11. Performs all other duties as assigned or required. Qualifications 1.… more